Two big statin stories – and both are wrong.

Friday 7th December 2012

  • Here are the banner headlines about statins we saw this week
  • Statistics can make your head hurt, but do they help your heart? There is a natural alternative
  • A brief note for anyone who is worried by all of this

During the week there were two newspaper articles about the effects of exercise and the dreaded statins on health.

One, in the Daily Express, shouted, ‘Statins are the key to long life’ and cited a new research article from The Lancet.

The other, slightly contradictory piece in the Daily Mail, read, ‘Doing the garden or going for a walk is better for your health than relying on statins, study says’.

I couldn’t believe that two similar studies had been published that seemed to have come to differing conclusions.

So I set to work to find out more.

Naturally, I was somewhat peevish about the whole thing as I am no fan of statins or the gay abandon with which they are dished out.

As far as The Express story went, I could see the statin PR machine working overtime to get that story out there; although this is one paper that needs no urging to promote the use of pharmaceuticals.

Ever since I began writing the Good Life Letter in 2005 I have come to rely on this organ to give me the hyped view according to big business.

I even began to wonder if its owner, Richard Desmond, or its editor (currently Peter Whittow) were board members of drug giants Pfizer or some such!

The Mail's take intrigued me as they were following a line which implied that they weren’t wholly in favour of the drug approach – good.

The source revealed

I began to read both articles to find out where they had got their stories from, quite expecting to discover the beginnings of a long trail.

But no, paint me pink and call me Mary … they were both quoting the self same piece of research.

But how had they come to write such differing headlines?

The original research(1) was a paper entitled ‘Interactive effects of fitness and statin treatment on mortality risk in veterans with dyslipidaemia: A cohort study’ published in the online edition of The Lancet on the 28th November.

(For those who aren’t sure, dyslipidaemia basically means abnormal amounts of cholesterol in the blood)

The study tracked over 10,000 older folk in the US and found out how many of them were on statins, what their levels of fitness were … and then counted how many of them shuffled off in ten years.

The ambition of the trial was stated as being to determine the combined effects of drug therapy and exercise on ‘all-cause mortality risk’.

The primary findings were … and I quote:

‘Statin treatment and increased fitness are independently associated with low mortality among dyslipidaemic individuals. The combination of statin treatment and increased fitness resulted in substantially lower mortality risk than either alone, reinforcing the importance of physical activity for individuals with dyslipidaemia’.

I can see where the Express got their headline, but am I alone in understanding that the important part in the findings was the importance of the exercise rather than the pill popping bit? Thought not.

I was about to leave it there, satisfied that my sleuthing had put paid to the erroneous and over hyped power play for statins … but then something else caught my eye.

Lies … damned lies … and statistical calculations!

There was a table that showed how the trialists in the study were selected.

A couple of lines caught my eye.

It showed that 64% of the African American participants were in the statin users group, whilst 63% of the white participants were in the non statin user column.

Furthermore, 70% of those in the statin user group were also taking cardiovascular medication, compared to only 30% in the non statin group.

This struck me as having the possibility of causing bias in the results; remember the research team was looking at ‘all-cause mortality risk’.

If they were only looking at how many people in the sample sets died in the period irrespective of the reason why, then any skewing in their population would affect the data ... so was there any significance in this imbalance?

Only something very significant as it happens!

I found a 2008 paper published by Flack et. al.(2) (and incidentally funded by Pfizer!) which states that:

‘African Americans have among the highest overall mortality due to coronary heart disease of any racial ethnic group in the United States. Compared to whites, African Americans have a 2-fold greater risk of stroke and a higher prevalence of hypertension’.

To my mind this means that the results of the trials were hardly a fair comparison.

If the statin user group contained a disproportionate number of people who are genetically more likely to succumb to serious heart disease which is then being medicated, how do the results show the benefits of statins?

If a subject is receiving more than one type of drug, where is the evidence for just the effects of one of them?

Having worked myself into a frenzy of statistical compromise and indignation, I’m not sure that the conclusions drawn by the research team show a clear outcome at all.

But one thing I am sure of is that the Express was plain wrong.

A message for the concerned

Of course, I realise that many of you are taking statins and may be worried about doing so.

As I’ve said in the past, there are alternatives that your doctor should be able to discuss with you, and also information available about natural ways to manage disruption to your cholesterol levels one of which can be found here.

In many instances statin preparations are the right medication for you to be on, but it doesn’t hurt to ask the question at your next GP appointment.

There is so much information now available to show that these types of drugs aren’t the cure all that some would have us believe, and unless we challenge our medics we don’t always get a choice.

Do we?


Yours, as always

References
(1) Kokkinos et al; (2012); Interactive effects of fitness and statin treatment on mortality risk in veterans with dyslipidaemia: A cohort study. The Lancet 28 November 2012
(2) Flack et al; (2008); Improved Attainment of Blood Pressure and Cholesterol Goals Using Single-Pill Amlodipine/Atorvastatin in African Americans: The CAPABLE Trial. Mayo Clinic Proceedings January 2008;83(1):35-45

 

 

 

 


 

 

 

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